title: [Anesthetic management of total hysterectomy in a patient with pulmonary thromboembolism].
abstract: We report anesthetic management of a 38-year-old woman with pulmonary thromboembolism for total hysterectomy. She had been taking oral contraceptives for adenomyosis of the uterus. She had thrombi in the arteries from pulmonary trunk to bilateral main pulmonary arteries. Thrombolytic and anticoagulant therapies did not decrease the thrombi. Removal of the swollen uterus suspected to be the origin of the thrombi, rather than thromboembolectomy, was scheduled. Cannulation for percutaneous cardiopulmonary support was set up just in case of hemodynamic derangement, before the surgery. Cardiac contraction was evaluated with transesophageal echocardiography during the surgery. There was no untoward perioperative event. Pulmonary thromboembolectomy was not done because the postoperative CT revealed shrinkage of the pulmonary thrombi after anticoagulation treatment.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Okuda
authors.forename: Kenji
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nitahara
authors.forename: Naomi
authors.initials: N
authors.lastname: Nakayama
authors.forename: Shingo
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Higa
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D011655:Pulmonary Embolism / Q000150:complications* / Q000188:drug therapy / Q000209:etiology
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents